摘要
目的探讨呼吸机辅助呼吸对急性脑出血合并呼吸衰竭患者血气指标、神经功能的改善作用。方法选取长沙市第四医院2016年1月～2017年12月收治的急性脑出血后并发呼吸衰竭患者88例,根据患者抢救结果分为救治成功组(35例)和失败组(53例)。比较两组患者治疗前后平均动脉血压(MAP)、动脉血氧分压(PaCO_2)、动脉血二氧化碳分压(PaCO_2)、p H值,比较救治成功组患者治疗前后不同时间的神经缺损功能评分(NIHSS)、急性生理与慢性健康评分(APACHEⅡ)、格拉斯哥昏迷评分(GCS)。结果通气治疗48 h后,两组的PaO_2、p H值较通气治疗前均显著的提高(P<0.05);成功组的MAP、PaCO_2值较通气治疗前均显著降低(P<0.05);失败组的PaCO_2值较通气治疗前均显著的降低(P<0.05),MAP值较治疗前变化不明显(P>0.05)。成功组患者的NIHSS评分在治疗7、28 d后均较治疗前显著降低(P<0.05);通气治疗48 h后,成功组患者的GCS评分较通气治疗前均显著提高(P<0.05),APACHEⅡ评分较通气治疗前均显著降低(P<0.05),而失败组GCS、APACHEⅡ评分较治疗前变化不明显(P>0.05)。结论呼吸机辅助呼吸对急性脑出血合并呼吸衰竭患者的血气功能具有显著的改善作用,对于救治成功患者的神经功能恢复具有促进作用。
Objective To explore the effect of ventilator assisted breathing on blood gas index and nerve function in patients with acute cerebral hemorrhage complicated with respiratory failure. Methods From January 2016 to December2017, in the Fourth Hospital of Changsha City, 88 patients with acute cerebral hemorrhage complicated with respiratory failure were selected, according to the results of the patient rescue result, they were divided into succeed group(35 cases)and failure group(53 cases). The MAP, PaO2, PaCO2, and p H values of the two groups were compared before and after treatment, the NIHSS, APACHE Ⅱ, and GCS scores of patients in the succeed group were compared at different time points before and after treatment. Results After 48 h of ventilation treatment, the PaO2 and p H values in the two groups significantly improved than before the ventilation treatment(P < 0.05);the values of MAP and PaCO2 in the succeed group significantly reduced than before the ventilation treatment(P < 0.05);the PaCO2 values in the failure group significantly reduced than before the ventilation treatment(P < 0.05), the MAP value in the failure group did not significantly changed compared with before treatment(P > 0.05). The NIHSS scores in the succeed group significantly reduced after treated for 7, 28 d compared with before treatment(P < 0.05);after 48 h of ventilation treatment, the GCS scores in the succeed group significantly increased than before the ventilation treatment(P < 0.05), the APACHEⅡ scores significantly reduced than before ventilation(P < 0.05);the GCS, APACHEⅡ scores in the failure group without significantly changed compared with before treatment(P > 0.05). Conclusion Ventilator-assisted breathing can significantly improve the blood gas function of patients with acute cerebral hemorrhage complicated with respiratory failure, and promote the recovery of nerve function of successful patients.
作者
王加栋
黄艳
武蓉
谭明万
刘军
WANG Jiadong;HUANG Yan;WU Rong;TAN Mingwan;LIU Jun(Department of Emergency, the Fourth Hospital of Changsha City, Hu′nan Province, Changsha 410000, China)
出处
《中国医药导报》
CAS
2019年第7期84-87,共4页
China Medical Herald
基金
湖南省卫生计生委科研计划课题项目(B20180479)
关键词
呼吸机
急性脑出血
呼吸衰竭
血气指标
神经功能
Ventilator
Acute cerebral hemorrhage
Respiratory failure
Blood gas index
Neurological function
